Federal Update
Vital Signs: March 2013
Back-dating of Penalty Programs Are of Concern
The AMA, along with specialty and state medical societies, has encouraged the Centers for Medicare and Medicaid Services (CMS) to address serious concerns about an onslaught of overlapping regulations that affect physicians. Programs with overlapping timelines include the penalties under the electronic prescribing program, physician quality reporting system and electronic health record incentive programs, the value-based modifier, as well as the transition to ICD-10.
The physician community is especially concerned about the back-dating of penalty programs, such as performance in 2013 determining penalties for 2015, and the lack of alignment in the requirements for the various programs. The MMS has joined with the AMA on these issues. The list of total activities is extensive but includes e-prescribing, CMS Audits, ICD-10 implementation, comparative effectiveness research, and ACOs. In addition to the regulatory challenges at the federal level, a number of national organizations have developed model policy and regulations to be used by state regulators. Groups such as the National Association of Insurance Commissioners (NAIC), the National Governors Association, and the National Conference of State Legislators all engage in this type of organizational advocacy, which can have a strong effect on local regulations and, subsequently, the practice of medicine in Massachusetts. For example, the AMA worked closely with the NAIC to develop model regulations around strict medical loss ratios for health plans.
The AMA's Advocacy Resource Center (ARC) works closely with states, including Massachusetts, in identifying, developing, and advocating issues that are important to physicians and their patients. More often than not, the AMA is the sole voice on behalf of physicians and their patients before these organizations. The MMS strongly values this relationship with the ARC and the work it does with states. In the coming year they will be focusing in on ACA implementation, including Medicaid expansion and reimbursement levels, scope of practice, prescription drug abuse, and medical liability reform.
- Charles Alagero, Esq.
Charles Alagero is the MMS representative to the ARC's Executive Board and welcomes member input on advocacy issues. For more information, contact him at calagero@mms.org.
